MEDICARE: DR. CAROL ANNE CARSON DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1095	NM

General Provider Information

NPI Number	:	1477616829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL ANNE CARSON DC

Provider Business Mailing Address
First Line	:	205 W. BOUTZ RD.
Second Line	:	BUILDING 4 SUITE 2
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3259
Country	:	US
Telephone Number	:	575-523-8604
Fax Number	:	575-526-2471

Provider Business Practice Location Address
First Line	:	205 W BOUTZ RD
Second Line	:	BUILDING 4 SUITE 2
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3262
Country	:	US
Telephone Number	:	575-523-8604
Fax Number	:	575-526-2471

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	12/20/2011

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Directions to “ DR. CAROL ANNE CARSON DC” Practice Location

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